(a)
The roster to be kept by each precinct board shall be substantially in the following form:
Roster
of the ________ election held in the ________ precinct ________ district, County of ________, on the ________ day of ________, 20___.Following are the voters of above precinct desiring to vote under Sections 14216, 14218, 14278, and 14284 of the Elections Code:
No.
Signature of voter
Residence of voter
1
2
3
etc.
We hereby certify that all voters whose signatures appear hereinbefore in this roster voted this day excepting the following who, after signing the roster, failed to vote or were challenged and denied the right to vote.
No.Name
No.Name
We further certify that the number of voters who voted in this precinct at this election is ____, and that the above list of voters, less those who did not vote as enumerated, constitutes the roster of this precinct for this election.
We further certify that the total number of official ballots received, voted, rejected, spoiled and canceled, found in the ballot container and the number accounted for is as indicated on the ballot statement.
We further certify that the assisted voters list and challenge list show a complete list of all voters assisted or challenged.
Clerk
Clerk
Clerk
Inspector
Judge
Judge
All members of the precinct board shall sign this certificate.
(b)
When votes are counted at the precinct, all members of the board shall also sign the certificate of performance prescribed in Section 15280.